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Background <p>We report a computational fluid dynamics (CFD)-based analysis of an unsuccessful open fenestration for aortic dissection with mesenteric malperfusion.</p> Case presentation <p>A 75-year-old male was admitted for acute type B aortic dissection complicated by mesenteric malperfusion. He had a concomitant infrarenal abdominal aneurysm, prompting surgical infrarenal fenestration. Intraoperatively, the proximal intimal flap was resected near the renal arteries, and the aneurysm was replaced with a prosthetic graft. Despite the intervention, mesenteric malperfusion worsened, requiring additional endovascular aortic repair. CFD analysis revealed persistent false lumen flow and true lumen compression due to a large entry tear and residual proximal anastomotic stenosis.</p> Conclusion <p>CFD analysis suggests that a large entry tear and residual stenosis from insufficient fenestration may result in inadequate false lumen depressurization.</p>

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Unsuccessful aortic fenestration for aortic dissection complicated with mesenteric malperfusion analyzed using computational fluid dynamics: a case report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月17日

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  • Shoki Iwanaga,
  • Naoyuki Kimura,
  • Shuta Imada,
  • Mutsumi Mizoguchi,
  • Mamoru Arakawa,
  • Hirohiko Akutsu,
  • Koji Kawahito,
  • Masanori Nakamura

摘要

Background

We report a computational fluid dynamics (CFD)-based analysis of an unsuccessful open fenestration for aortic dissection with mesenteric malperfusion.

Case presentation

A 75-year-old male was admitted for acute type B aortic dissection complicated by mesenteric malperfusion. He had a concomitant infrarenal abdominal aneurysm, prompting surgical infrarenal fenestration. Intraoperatively, the proximal intimal flap was resected near the renal arteries, and the aneurysm was replaced with a prosthetic graft. Despite the intervention, mesenteric malperfusion worsened, requiring additional endovascular aortic repair. CFD analysis revealed persistent false lumen flow and true lumen compression due to a large entry tear and residual proximal anastomotic stenosis.

Conclusion

CFD analysis suggests that a large entry tear and residual stenosis from insufficient fenestration may result in inadequate false lumen depressurization.